Preventing eclampsia : an interview with Tom Brewer, MD

Townsend Letter for Doctors and Patients, Nov, 2004 by CJ Puotinen

Despite a century of research, American medicine offers as little today for the prevention and treatment of eclampsia (traditionally called toxemia) as it did a hundred years ago. This progressive and potentially fatal condition remains a leading cause of miscarriage, premature birth, and infant mortality in the United States and around the world. An estimated 50,000 women die every year from eclampsia.

The condition's name is derived from the Greek word eklampsia, which means a sudden flashing or onslaught, an appropriate term for the rapidly developing system failures that characterize this medical emergency. Hypertension, severe edema, and protein in the urine are the signature symptoms of eclampsia, which adversely affects the brain, kidneys, liver, and lungs. Other common symptoms include headaches, nausea and vomiting, decreased urine output, changes in mental status, agitation and confusion, pain in the upper right abdomen, shortness of breath, sudden weight gain, and visual impairment. If the condition progresses to its final stage, the mother-to-be develops seizures or goes into a coma.

Extensive research notwithstanding, the cause of eclampsia remains a medical mystery. The preferred treatments are bed rest, dietary restrictions, prescription diuretics, and medication for hypertension. The preferred cure is delivery of the infant, usually months premature, by induced labor or Caesarian section.

To Tom Brewer, MD, these methods are worse than useless; they're dangerous. The cause of eclampsia and its simple cure, he says, have been known for decades. Beginning in the 1920s and '30s, medical journals have published dozens of scientific studies based on clinical observation as well as statistical and epidemiological studies showing that eclampsia is an easily prevented nutritional disease. (1-75)

Now retired, Dr. Brewer enjoys a career as a lecturer and nutritional counselor for pregnant women. Thanks to electronic publishing, the books What Every Pregnant Woman Should Know and The Brewer Medical Diet, both of which describe his discoveries and recommendations, are available as ebooks at www.pregnancybooks online.com. The Blue Ribbon Baby Pages website (www.blueribbonbaby.org) details his dietary guidelines, along with case studies, scientific references, and other information for pregnant women. In addition, Dr. Brewer maintains a free information hotline at 802-388-0276.

Interview with Tom Brewer, MD

Q: How did you become interested in the importance of nutrition for a healthy pregnancy?

Dr. Brewer: I learned about the problem of eclampsia, or what I call the metabolic toxemia of late pregnancy, before I went to medical school. I was married and had a new baby, and we had a neighbor from Russia who often described conditions in that country and the toll they took on pregnant women. (7) Times were very hard, food was scarce, and many women died of hemorrhage or convulsions. The Russian people at that time believed such events were the will of God and that women were meant to suffer in childbirth, but my neighbor believed the problem was simply a lack of food.

So in 1947, when I got into medical school at Tulane University, which was at that time in the middle of a New Orleans slum, I saw the problems he described first-hand.

In my first year, I went to a lecture given by James Henry Ferguson, (16) an instructor who came from Chicago, where he had worked with W.J. Dieckmann, a professor from Germany. Professor Dieckmann believed that protein deficiencies and malnutrition were the cause of most of the problems he saw in Chicago. He was then chair of the Chicago Lying-In Hospital.

When Ferguson came to work at Charity Hospital, where Tulane then had an obstetrics ward, he gave several lectures on OB/GYN topics, and one was about toxemia pregnancy, as it was called in those days. He said we were faced with a disease that's common in poor people, common in people who don't have prenatal care, common in diabetics, and common in women who have twins.

As he listed the risk factors, I had a gestalt, a moment of insight. I already had in mind the observations of my Russian neighbor. Now I was hearing an expert talk about the risk factors of toxemia. I realized that this problem could only be due to one thing, and that's poor nutrition.

Q: Did any of your professors make this connection?

Dr. Brewer: None of them did. They were surrounded by poverty and malnutrition but, as far as I know, none of them ever considered that these conditions might have anything to do with the problems we saw every day, like worms in children, miscarriages, and various diseases. My professors definitely did not share Ferguson's views. They were primarily surgeons. They were interested in performing C-sections, removing fibroids and ovarian cysts, performing hysterectomies, and so on.

So there, in my first year of medical school, I developed an antagonistic view.

When I started working with patients, I was on a ward where there were 20 beds with women who had this disease, toxemia pregnancy. Their blood pressure was up, their bodies were swollen, and they had a history of not having a decent diet. I learned this by talking with them. That's considered anecdotal, not verifiable, not from a clinical trial, not statistically significant, and so on. I've never been big on the statistical approach because each individual mother is important. Each one faces her own troubles.